A 3-year-old with chronic stool withholding requiring laxatives is being prepared for third-party reimbursement. Which diagnosis should the nurse practitioner use to facilitate reimbursement?

• A. Elimination disorder
• B. Encopresis
• C. Altered elimination pattern
• D. Parenting alteration

Answer: (B)

Encopresis is the appropriate diagnosis because it captures fecal incontinence that results from chronic stool withholding and constipation, a common pattern in young children who are treated with laxatives. When stool is held in, it becomes impacted, defecation can be painful, and leakage of liquid stool around the hardened mass leads to incontinence—this combination is classic encopresis. Labeling it this way provides a specific, recognized medical diagnosis that aligns with the child’s functional defecation disturbance and supports reimbursement for the underlying condition and its management. The other options are too broad or not standard medical diagnoses for billing: an elimination disorder is a broad category, altered elimination pattern is vague, and parenting alteration refers to family dynamics rather than a medical condition.